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Schilling S, Armaou M, Morrison Z, Carding P, Bricknell M, Connelly V. "Trust people you've never worked with" - A social network visualization of teamwork, cohesion, social support, and mental health in NHS Covid personnel. Front Psychol 2024; 15:1293171. [PMID: 38445057 PMCID: PMC10913897 DOI: 10.3389/fpsyg.2024.1293171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/16/2024] [Indexed: 03/07/2024] Open
Abstract
Background The unprecedented rapid re-deployment of healthcare workers from different care pathways into newly created and fluid COVID-19 teams provides a unique opportunity to examine the interaction of many of the established non-technical factors for successful delivery of clinical care and teamwork in healthcare settings. This research paper therefore aims to address these gaps by qualitatively exploring the impact of COVID work throughout the pandemic on permanent and deployed personnel's experiences, their ability to effectively work together, and the effect of social dynamics (e.g., cohesion, social support) on teamwork and mental health. Methods Seventy-five interviews were conducted across the UK between March and December 2021 during wave 2 and 3 of COVID-19 with 75 healthcare workers who were either permanent staff on Intensive Care/High Dependency Units used as COVID wards, had been rapidly deployed to such a ward, or had managed such wards. Work Life Balance was measured using the WLB Scale. Interview transcripts were qualitatively coded and thematic codes were compared using network graph modeling. Results Using thematic network analysis, four overarching thematic clusters were found, (1) teamwork, (2) organizational support and management, (3) cohesion and social support, and (4) psychological strain. The study has three main findings. First, the importance of social factors for teamwork and mental health, whereby team identity may influence perceptions of preparedness, collaboration and communication, and impact on the collective appraisal of stressful events and work stressors. Secondly, it demonstrates the positive and negative impact of professional roles and skills on the development of teamwork and team identity. Lastly the study identifies the more pronounced negative impact of COVID work on deployed personnel's workload, mental health, and career intentions, exacerbated by reduced levels of social support during, and after, their deployment. Conclusion The thematic network analysis was able to highlight that many of the traditional factors associated with the successful delivery of patient care were impeded by pandemic constraints, markedly influencing personnel's ability to work together and cope with pandemic work stressors. In this environment teamwork, delivery of care and staff well-being appear to depend on relational and organizational context, social group membership, and psycho-social skills related to managing team identity. While results hold lessons for personnel selection, training, co-location, and organizational support during and after a pandemic, further research is needed into the differential impact of pandemic deployment on HCWs mental health and teamwork.
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Affiliation(s)
- Stefan Schilling
- Psychology, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
- Department of Psychology, Health and Professional Development, Oxford Brookes University, Oxford, United Kingdom
| | - Maria Armaou
- School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Zoe Morrison
- Aberdeen Business School, Robert Gordon University, Aberdeen, United Kingdom
| | - Paul Carding
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom
| | - Martin Bricknell
- King’s College London, School of Security Studies, London, United Kingdom
| | - Vincent Connelly
- Department of Psychology, Health and Professional Development, Oxford Brookes University, Oxford, United Kingdom
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Koushan K, Horne L, Samra G. Are junior doctors' attitudes towards clinical incidents shifting in the post-COVID era? Introducing the 'Manalayil effect'. Future Healthc J 2023; 10:65-66. [PMID: 38406722 PMCID: PMC10884627 DOI: 10.7861/fhj.10-3-s65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Affiliation(s)
| | - Laura Horne
- Blackpool Victoria Hospital NHS Foundation Trust, Blackpool, UK
| | - Gurkaran Samra
- Blackpool Victoria Hospital NHS Foundation Trust, Blackpool, UK
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Piel J, Hörold M, Brandstetter S, Drewitz KP, Hrudey I, Schmitt R, Apfelbacher C. COVID-19 crisis management of German ICU clinicians in leadership - a metaphor analysis. Front Public Health 2023; 11:1160094. [PMID: 37663843 PMCID: PMC10470881 DOI: 10.3389/fpubh.2023.1160094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/19/2023] [Indexed: 09/05/2023] Open
Abstract
The COVID-19 pandemic coincided with an already long-standing crisis in health systems around the world characterized by economic pressure and increasing staff shortage. "Crisis" became a global metaphor to convey collective experiences of the COVID-19 threat. Little is known on how crisis metaphors influence thought and speech on crisis management and the challenging staff situation of intensive care unit (ICU) clinicians in leadership positions and how they act. Therefore, we were interested in (1) which metaphorical concepts ICU clinicians in leadership use to express experiences and strategies in dealing with coinciding crises, (2) how these change over time, and (3) how metaphors in speech reveal self-images of crisis management. We conducted a systematic metaphor analysis focusing on data from three participants of a qualitative interview study with twenty-four healthcare professionals in ICUs in Germany. The participants were interviewed at two time points between April 2020 and March 2021. We identified and reconstructed metaphorical concepts of three interviewees (ICU clinicians in leadership) with regard to the pandemic management, and developed a typology based on the dimensions of mood, modus operandi, location, and scope. The typology consists of eight self-images (protagonists) for the crisis management of ICU clinicians in leadership, such as the figure of the soldier ("to unite everyone behind this flag"), the distributor ("sometimes it is a crazy patchwork [wahnsinniges Gestückel]") or the critic ("we are the fool for everything"). They embody different qualities of a leader and refer to intra- and inter-role conflicts within multiple crisis conditions. Metaphor analysis reveals different self-images of ICU leadership clinicians in relation to crisis management. This illustrates that thinking and perceptions of crisis management may strongly differ between and within leaders and may change over the course of crises. Our findings highlight the need both to improve knowledge on challenges associated with leadership in crises and preparedness, and to support clinicians in their leadership by recognizing and addressing differences and changes in leaders' self-image.
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Affiliation(s)
- Julia Piel
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Madlen Hörold
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Susanne Brandstetter
- University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany
| | - Karl-Philipp Drewitz
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Ilona Hrudey
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Rudolf Schmitt
- Faculty of Social Sciences, University of Applied Sciences Zittau-Görlitz, Görlitz, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto von Guericke University Magdeburg, Magdeburg, Germany
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Conneely M, Packer KC, Bicknell S, Janković J, Sihre HK, McCabe R, Copello A, Bains K, Priebe S, Spruce A, Jovanović N. Exploring Black and South Asian women's experiences of help-seeking and engagement in perinatal mental health services in the UK. Front Psychiatry 2023; 14:1119998. [PMID: 37077277 PMCID: PMC10109459 DOI: 10.3389/fpsyt.2023.1119998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/06/2023] [Indexed: 04/21/2023] Open
Abstract
Background and aims In the United Kingdom (UK), Black and South Asian women are less likely than White British women to access support from perinatal mental health services, despite experiencing similar, or higher, levels of distress. This inequality needs to be understood and remedied. The aim of this study was to answer two questions: how do Black and South Asian women experience (1) access to perinatal mental health services and (2) care received from perinatal mental health services? Method Semi-structured interviews were conducted with Black and South Asian women (n = 37), including four women who were interviewed with an interpreter. Interviews were recorded and transcribed line-by-line. Data were analyzed using framework analysis, by an ethnically diverse multidisciplinary team of clinicians, researchers and people with lived experience of perinatal mental illness. Results Participants described a complex interplay of factors that impacted on seeking, and receiving help, and benefiting from services. Four themes emerged that captured the highly varied experiences of individuals: (1) Self-identity, social expectations and different attributions of distress deter help-seeking; (2) Hidden and disorganized services impede getting support; (3) The role of curiosity, kindness and flexibility in making women feel heard, accepted and supported by clinicians; (4) A shared cultural background may support or hinder trust and rapport. Conclusion Women described a wide range of experiences and a complex interplay of factors impacting access to, and experience of, services. Women described services as giving them strength and also leaving them disappointed and confused about where to get help. The main barriers to access were attributions related to mental distress, stigma, mistrust and lack of visibility of services, and organizational gaps in the referral process. These findings describe that many women feel heard, and supported by services, reporting that services provide a high quality of care that was inclusive of diverse experiences and understandings of mental health problems. Transparency around what PMHS are, and what support is available would improve the accessibility of PMHS.
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Affiliation(s)
- Maev Conneely
- Unit for Social and Community Psychiatry, WHO Collaborating Centre, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- East London NHS Foundation Trust, London, United Kingdom
| | - Katy C. Packer
- Camden and Islington NHS Foundation Trust, London, United Kingdom
- North East London NHS Foundation Trust, London, United Kingdom
| | - Sarah Bicknell
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
| | - Jelena Janković
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Harpreet Kaur Sihre
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Rosemarie McCabe
- School of Health and Psychological Sciences, City, University of London, London, United Kingdom
| | - Alex Copello
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Kiren Bains
- Birmingham and Solihull Mental Health Foundation Trust, Birmingham, United Kingdom
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- East London NHS Foundation Trust, London, United Kingdom
| | - Amy Spruce
- Action on Postpartum Psychosis, London, United Kingdom
| | - Nikolina Jovanović
- Unit for Social and Community Psychiatry, WHO Collaborating Centre, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- East London NHS Foundation Trust, London, United Kingdom
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Barnicot K, McCabe R, Bogosian A, Papadopoulos R, Crawford M, Aitken P, Christensen T, Wilson J, Teague B, Rana R, Willis D, Barclay R, Chung A, Rohricht F. Predictors of Post-Traumatic Growth in a Sample of United Kingdom Mental and Community Healthcare Workers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3539. [PMID: 36834236 PMCID: PMC9965513 DOI: 10.3390/ijerph20043539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Experiences of adversity can generate positive psychological effects alongside negative impacts. Little research to date has evaluated predictors of post-traumatic growth in mental or community healthcare workers during the COVID-19 pandemic. Following a survey of 854 community and mental healthcare staff in the United Kingdom in July to September 2020, multiple linear regression was used to determine the association between hypothesised risk and protective factors (personal, organisational and environmental variables) and total scores on the Post-traumatic Growth Inventory-Short Version. Positive self-reflection activities, black and minority ethnic status, developing new healthcare knowledge and skills, connecting with friends and family, feeling supported by senior management, feeling supported by the UK people, and anxiety about the personal and work-related consequences of COVID-19 each significantly independently predicted greater post-traumatic growth. Working in a clinical role and in mental healthcare or community physical healthcare predicted lower post-traumatic growth. Our research supports the value of taking an organisational growth-focused approach to occupational health during times of adversity, by supporting staff to embrace opportunities for personal growth. Valuing staff's cultural and religious identity and encouraging self-reflective activities, such as mindfulness and meditation, may help to promote post-traumatic growth.
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Affiliation(s)
- Kirsten Barnicot
- Department of Health Services Research and Management, University of London, London WC1E 7HU, UK
- Department of Psychiatry, Imperial College London, London W12 0NN, UK
| | - Rose McCabe
- Department of Health Services Research and Management, University of London, London WC1E 7HU, UK
| | - Angeliki Bogosian
- Department of Health Services Research and Management, University of London, London WC1E 7HU, UK
| | - Renos Papadopoulos
- Department of Psychosocial and Psychoanalytic Studies, University of Essex, Essex CO4 3SQ, UK
| | - Mike Crawford
- Department of Psychiatry, Imperial College London, London W12 0NN, UK
| | | | | | - Jonathan Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich NR6 5BE, UK
| | - Bonnie Teague
- Norfolk and Suffolk NHS Foundation Trust, Norwich NR6 5BE, UK
| | - Ravi Rana
- East London NHS Foundation Trust, London E1 8DE, UK
| | - Donna Willis
- East London NHS Foundation Trust, London E1 8DE, UK
| | - Ryan Barclay
- East London NHS Foundation Trust, London E1 8DE, UK
| | - Amy Chung
- East London NHS Foundation Trust, London E1 8DE, UK
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Serrano-Gallardo P, Manzano A, Pawson R. Non-pharmaceutical interventions during COVID-19 in the UK and Spain: a rapid realist review. OPEN RESEARCH EUROPE 2022; 2:52. [PMID: 37645319 PMCID: PMC10446037 DOI: 10.12688/openreseurope.14566.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 08/31/2023]
Abstract
The paper is located at the crossroads of two modern intellectual movements. The first, evidence-based policy, seeks to locate vital information that will inform and improve key policy decisions on such matters as population health, social welfare, and human wellbeing. The second, complexity theory, describes the nature of the social world and perceives human action as persistently adaptive and social institutions as incessantly self-transformative. The first assumes that policies and programmes can achieve sufficient control to meet specific and measurable objectives. The second assumes that social actions are sufficiently capricious so that the society never conforms to anyone's plans - even those of the most powerful. The unparalleled resources committed to control the unprecedented attack of the COVID-19 pandemic are the epitome of complexity. The long struggle to contain the virus thus constitutes an ideal test bed to investigate this paradigmatic split. The paper undertakes this mission - focusing specifically on the effectiveness non-pharmaceutical interventions and examining evidence from the UK and Spain.
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Affiliation(s)
| | - Ana Manzano
- School of Sociology and Social Policy, University of Leeds, Leeds, LS2 9JT, UK
| | - Ray Pawson
- School of Sociology and Social Policy, University of Leeds, Leeds, LS2 9JT, UK
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Morath LP, Burström B, Liljas AEM. Care home managers' views on the media coverage of COVID-19 outbreaks in care homes for older adults: A case study in Stockholm. Int J Older People Nurs 2022; 17:e12483. [PMID: 35699305 PMCID: PMC9350000 DOI: 10.1111/opn.12483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/17/2022] [Accepted: 05/16/2022] [Indexed: 12/01/2022]
Abstract
The COVID‐19 pandemic has particularly affected older adults and resulted in high rates of infections and deaths in care homes. We have conducted a case study in which three managers of care homes for older adults in central Stockholm have shared their thoughts on the media coverage of care homes for older adults during the COVID‐19 pandemic. We analysed the data using conventional content analysis and identified three themes and five categories. The results show that the managers experienced the media coverage of care homes during the pandemic to be negative and incomplete, causing feelings of sadness and shame amongst themselves and their staff. The negative media coverage further generated added workload as they had to arrange for discussions to answer questions by staff and close relatives of the residents. Informants also thought that there is a lack of knowledge about the role of care homes and subsequently what to expect of them. Finally, informants reported that the pandemic might create an opportunity for system‐level policy changes. In light of this, we discuss possible victim blaming of staff and how greater public awareness of the care home sector could facilitate for a debate on policy changes and the low social status of caring for older adults.
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Affiliation(s)
- Lenke P Morath
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Bo Burström
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Ann E M Liljas
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
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Gillen P, Neill RD, Manthorpe J, Mallett J, Schroder H, Nicholl P, Currie D, Moriarty J, Ravalier J, McGrory S, McFadden P. Decreasing Wellbeing and Increasing Use of Negative Coping Strategies: The Effect of the COVID-19 Pandemic on the UK Health and Social Care Workforce. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2022; 3:26-39. [PMID: 36417265 PMCID: PMC9620918 DOI: 10.3390/epidemiologia3010003] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/07/2022] [Accepted: 01/14/2022] [Indexed: 12/14/2022]
Abstract
Many health and social care (HSC) professionals have faced overwhelming pressures throughout the COVID-19 pandemic. As the current situation is constantly changing, and some restrictions across the UK countries such as social distancing and mask wearing in this period (May-July 2021) began to ease, it is important to examine how this workforce has been affected and how employers can help rebuild their services. The aim of this study was to compare cross-sectional data collected from the HSC workforce in the UK at three time points during the COVID-19 pandemic: Phase 1 (May-July 2020), Phase 2 (November 2020-January 2021) and Phase 3 (May-July 2021). Respondents surveyed across the UK (England, Wales, Scotland, Northern Ireland) consisted of nurses, midwives, allied health professionals, social care workers and social workers. Wellbeing and work-related quality of life significantly declined from Phase 1 to 3 (p < 0.001); however, no significant difference occurred between Phases 2 and 3 (p > 0.05). Respondents increasingly used negative coping strategies between Phase 1 (May-July 2020) and Phase 3 (May-July 2021), suggesting that the HSC workforce has been negatively impacted by the pandemic. These results have the potential to inform HSC employers' policies, practices, and interventions as the workforce continues to respond to the COVID-19 virus and its legacy.
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Affiliation(s)
- Patricia Gillen
- School of Nursing, Jordanstown Campus, Ulster University, Shore Road, Newtownabbey BT37 0QB, UK;
- Southern Health and Social Care Trust, 10 Moyallen Road, Gilford BT63 5JX, UK;
- Correspondence:
| | - Ruth D. Neill
- School of Applied Social Policy Sciences, Magee Campus, Ulster University, Londonderry BT48 7JL, UK; (R.D.N.); (P.N.)
| | - Jill Manthorpe
- NIHR Health and Social Care Workforce Research Unit, King’s College London, 22 Kingsway, London WC2B 6LE, UK;
| | - John Mallett
- School of Psychology, Coleraine Campus, Ulster University, Cromore Road, Coleraine BT52 1SA, UK;
| | - Heike Schroder
- Queen’s Management School, Queen’s University Belfast, Riddel Hall, 185 Stranmillis Road, Belfast BT9 5EE, UK; (H.S.); (D.C.)
| | - Patricia Nicholl
- School of Applied Social Policy Sciences, Magee Campus, Ulster University, Londonderry BT48 7JL, UK; (R.D.N.); (P.N.)
| | - Denise Currie
- Queen’s Management School, Queen’s University Belfast, Riddel Hall, 185 Stranmillis Road, Belfast BT9 5EE, UK; (H.S.); (D.C.)
| | - John Moriarty
- School of Social Sciences, Education and Social Work, Queen’s University Belfast, 69–71 University Street, Belfast BT7 1HL, UK;
| | - Jermaine Ravalier
- School of Science, Bath Spa University, Newton Park, Newton St. Loe, Bath BA2 9BN, UK;
| | - Susan McGrory
- School of Nursing, Jordanstown Campus, Ulster University, Shore Road, Newtownabbey BT37 0QB, UK;
| | - Paula McFadden
- Southern Health and Social Care Trust, 10 Moyallen Road, Gilford BT63 5JX, UK;
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